Abstract
BackgroundPreschoolers’ energy balance-related behaviours (EBRBs) and self-regulation skills are important for their later health. Few preschool-based interventions aiming to promote preschoolers’ EBRBs and self-regulation skills, simultaneously reducing differences in EBRBs, due to children’s socio-economic status (SES) background, have been conducted. This study will present the Increased Health and Wellbeing in Preschools (DAGIS) intervention development process applying the Intervention Mapping (IM) framework.MethodsThe development of the DAGIS intervention study, a preschool level clustered randomized controlled trial (RCT), was based on the IM framework. The protocol in IM guides the development process of an intervention through six steps: needs assessment and logic model of the problem, programme outcomes and objectives, design of the programme, production, implementation plan, and evaluation plan.ResultsThe needs assessment, part of the step 1 in IM, yielded the base for the DAGIS logic model of change. The model includes objectives related to changes in children’s EBRBs, self-regulation skills, and in psychosocial and physical environment that is determined by parents and early educators. A 22-week programme was developed, and materials for preschools and families were produced. A feasibility study of the recruitment processes, acceptability of the materials and methods, and implementation was conducted. The DAGIS intervention study was conducted September 2017–May 2018 as a clustered RCT including a comprehensive effectiveness and process evaluation. The process evaluation was run throughout the intervention targeting preschools and families.ConclusionA preschool-based family-involving programme was developed in the DAGIS intervention study by applying the IM protocol. It was a time- and resource-consuming process. However, the systematic planning, development, and running of the programme have reinforced a comprehensive evaluation, which is a strength in the intervention. The results from the evaluation will enhance the knowledge of how to promote EBRBs and self-regulation skills among preschoolers, and diminish SES differences in them.Trial registrationISRCTN57165350 (Prospectively registered January the 8th, 2015).
Highlights
Preschoolers’ energy balance-related behaviours (EBRBs) and self-regulation skills are important for their later health
This section describes results gained in each step of the planning process and how the results have been applied in the Increased Health and Wellbeing in Preschools (DAGIS) intervention development
Results in steps 1 and 2: understanding the problem and determining the theory and evidence base for the DAGIS intervention Factors influencing preschool children’s health behaviours and barriers to change The focus groups yielded valuable knowledge about the home and preschool context as promoters or barriers for EBRBs and results have been reported in detail elsewhere [28, 29]
Summary
Preschoolers’ energy balance-related behaviours (EBRBs) and self-regulation skills are important for their later health. Few preschool-based interventions aiming to promote preschoolers’ EBRBs and self-regulation skills, simultaneously reducing differences in EBRBs, due to children’s socio-economic status (SES) background, have been conducted. The effects on children’s EBRBs were not significant in the study, the sugary drink consumption decreased more among those belonging to the intervention arm that simultaneously promoted healthy EBRBs, and strengthened self-regulation skills, compared to the other intervention arms in which both components were not included [10]. In the intervention planning phase, the researchers should try to plan activities, which are able to reach those who need it most, in this case families with low SES backgrounds, and further on reduce the SES differences in EBRBs. In order to avoid stigmatization based on SES in a population wide intervention, an appropriate way might be to apply the proportionate universalism approach [15]. Few intervention studies have focused on narrowing SES differences in young children’s EBRBs [16, 17]
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